-
Neurosurgical Focus Jan 2017
Topics: Humans; Radiosurgery; Spinal Neoplasms
PubMed: 28041322
DOI: 10.3171/2016.10.FOCUS16433 -
Acta Neurochirurgica Dec 2018Radiosurgery (RS) and fractionated radiotherapy (FRT) are part of the therapeutic armamentarium for the management of cavernous sinus meningiomas. We propose a... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Radiosurgery (RS) and fractionated radiotherapy (FRT) are part of the therapeutic armamentarium for the management of cavernous sinus meningiomas. We propose a systematic review of the local tumor control and clinical outcomes after monofractionated radiosurgical treatment, including gamma knife radiosurgery (GKRS) and linear accelerator (Linac RS), or fractionated radiotherapy.
MATERIALS AND METHODS
The current review and meta-analysis adhered to the PRISMA guidelines. We performed a search in PubMed, Embase, and Medline based on the following mesh terms, used alone or in diverse combinations, in both title and abstract: "cavernous sinus," "meningioma," "radiosurgery," "gamma knife," "linac," "cyberknife," and "radiotherapy". We screened 425 studies. We selected 36 studies, matching all selection criteria: 24 for GK, 5 for Linac, and 7 for FRT.
RESULTS
Were included 2817 patients (GKRS, n = 2047, LinacRS, n = 350, FRT, n = 420). Half of patients benefited from upfront RS or FRT; the other half benefited from adjuvant RS or FRT (combined approach or tumor recurrence). The mean gross target volume (GTV) was smaller for RS as compared to FRT (p = 0.07). The median marginal doses were 13.9 Gy (range, 11 to 28) for GKRS and 14 Gy (range, 12.8 to 17.7) for LinacRS. For FRT, patients received a mean dose of 51.2 Gy (25.5 fractions, 1.85 Gy each). The mean overall follow-up values were 48 months (range, 15 to 89) for GKRS, 69 months (range, 46 to 87) for Linac, and 59.5 months (range, 33 to 83) for FRT. PFS at 5 years for GKRS, LinacRS, and FRT were respectively 93.6%, 95.6%, and 97.4% (p = 0.32, the Kruskal-Wallis). Monofractionated treatments (GKRS and LinacRS) induced more tumor volume regression than FRT (p = 0.001). Tumor recurrence or progression ranged between 3 and 5.8%, without statistically significant differences between modalities (p > 0.05). Trigeminal symptoms improved in approximately 54%, and III-IV-VI cranial nerves (CN) palsies improved in approximately 45%. After GKRS, visual acuity improved in 21% (not enough data available for other modalities). De novo deficits occurred in 5 to 7.5%. Adverse radiation effects appeared in 4.6 to 9.3% (all techniques pooled).
CONCLUSION
RS achieved a twice-higher rate of tumor volume regression than FRT. GKRS series reported an improvement in visual acuity in 21% of the cases. GKRS, Linac, and FRT provided similar clinical post therapeutic outcomes for the trigeminal and oculomotor CN.
Topics: Cavernous Sinus; Dose Fractionation, Radiation; Humans; Meningeal Neoplasms; Meningioma; Radiosurgery; Treatment Outcome
PubMed: 30393820
DOI: 10.1007/s00701-018-3711-9 -
Neuro-oncology Jun 2023A recent phase III trial (NCT01372774) comparing use of stereotactic radiosurgery [SRS] versus whole-brain radiation therapy [WBRT] after surgical resection of a single... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
A recent phase III trial (NCT01372774) comparing use of stereotactic radiosurgery [SRS] versus whole-brain radiation therapy [WBRT] after surgical resection of a single brain metastasis revealed that declines in cognitive function were more common with WBRT than with SRS. A secondary endpoint in that trial, and the primary objective in this secondary analysis, was to identify baseline biomarkers associated with cognitive impairment after either form of radiotherapy for brain metastasis. Here we report our findings on APOE genotype and serum levels of associated proteins and their association with radiation-induced neurocognitive decline.
METHODS
In this retrospective analysis of prospectively collected samples from a completed randomized clinical trial, patients provided blood samples every 3 months that were tested by genotyping and enzyme-linked immunosorbent assay, and results were analyzed in association with cognitive impairment.
RESULTS
The APOE genotype was not associated with neurocognitive impairment at 3 months. However, low serum levels of ApoJ, ApoE, or ApoA protein (all P < .01) and higher amyloid beta (Aβ 1-42) levels (P = .048) at baseline indicated a greater likelihood of neurocognitive decline at 3 months after SRS, whereas lower ApoJ levels were associated with decline after WBRT (P = .014).
CONCLUSIONS
Patients with these pretreatment serum markers should be counseled about radiation-related neurocognitive decline.
Topics: Humans; Brain Neoplasms; Retrospective Studies; Amyloid beta-Peptides; Cranial Irradiation; Radiosurgery; Cognitive Dysfunction
PubMed: 36472389
DOI: 10.1093/neuonc/noac262 -
Seminars in Radiation Oncology Jul 2017Many cancers can spread to the liver, often as the sole site of metastatic disease. For properly selected patients with limited hepatic disease and good performance... (Review)
Review
Many cancers can spread to the liver, often as the sole site of metastatic disease. For properly selected patients with limited hepatic disease and good performance status, an aggressive strategy involving radical local therapy to the site(s) of metastasis offers a chance for extended disease-free survivorship. The development of stereotactic body radiotherapy has inserted radiation therapy into the arsenal of valuable treatment options in this clinical setting. This article summarizes the latest advancements in the use of stereotactic body radiotherapy to treat liver metastases.
Topics: Disease-Free Survival; Humans; Liver Neoplasms; Radiosurgery
PubMed: 28577831
DOI: 10.1016/j.semradonc.2017.02.004 -
Technology in Cancer Research &... Jan 2018In recent years, the concept of oligometastases has become accepted and reports on stereotactic body radiotherapy as a treatment method have been published. Lesions in... (Review)
Review
In recent years, the concept of oligometastases has become accepted and reports on stereotactic body radiotherapy as a treatment method have been published. Lesions in the brain, lung, and liver have been reported as target lesions. However, lymph node oligometastases could be a good candidate for stereotactic body radiotherapy as well. In this study, the usability of stereotactic body radiotherapy for oligometastases to lymph nodes is assessed by researching for each primary site. As a result, we could consider that stereotactic body radiotherapy could be almost well applied for lymph node oligometastases from the breast, gynecological organs, and prostate. However, doubts remain concerning the usefulness of stereotactic body radiotherapy for cervical node metastases from head and neck cancer or for mediastinal node metastases from lung or esophageal cancer since late toxicities have occurred with a large radiation dose at hypofractionation to major vessels or the central respiratory tract, especially in patients with irradiation histories. In addition, high-dose irradiation is required to control lymph node metastases from colorectal cancer due to its radioresistance, and severe late adverse events would therefore occur in adjacent organs such as the gastrointestinal tract. In cases of lymph node oligometastases with a primary tumor in the stomach or esophagus, stereotactic body radiotherapy should be used limitedly at present because this patient population is not so large and these metastases are often located close to organs at risk. Because of the varied status of recurrence and varied conditions of patients, it is difficult to determine the optimal dose for tumor control. It might be reasonable to determine the treatment dose individually based on dose constraints of adjacent organs. The oligometastatic state is becoming more frequently identified with more sensitive methods of detecting such oligometastases. In addition, there seems to be another type of oligometastases, so-called induced oligometastases, following successful systemic treatment. To determine the optimal indication of stereotactic body radiotherapy for lymph node oligometastases, further investigation about the mechanisms of oligometastases and further clinical studies including a phase III study are needed.
Topics: Clinical Trials as Topic; Diagnostic Imaging; Humans; Lymph Nodes; Lymphatic Metastasis; Neoplasms; Radiosurgery; Radiotherapy Planning, Computer-Assisted; Treatment Outcome
PubMed: 30352542
DOI: 10.1177/1533033818803597 -
Neurological Sciences : Official... May 2017A short review of clinical use of radiosurgery in trigeminal neuralgia is offered. (Review)
Review
A short review of clinical use of radiosurgery in trigeminal neuralgia is offered.
Topics: Humans; Pain Measurement; Radiosurgery; Treatment Outcome; Trigeminal Neuralgia
PubMed: 28527088
DOI: 10.1007/s10072-017-2892-y -
Missouri Medicine 2015Lung stereotactic body radiation therapy (SBRT) is a novel and effective modality for treatment of early stage non-sail cell lung cancer (NSCLC), with expanding... (Review)
Review
Lung stereotactic body radiation therapy (SBRT) is a novel and effective modality for treatment of early stage non-sail cell lung cancer (NSCLC), with expanding indications in locally advanced and metastatic disease. Herein, we will review current treatment recommendations for early stage NSCLC, detail treatment planning of SBRT, and discuss future directions.
Topics: Carcinoma, Non-Small-Cell Lung; Humans; Lung Neoplasms; Radiosurgery
PubMed: 26606817
DOI: No ID Found -
The Veterinary Clinics of North... Sep 2019Stereotactic radiotherapy (SRT) involves the precise delivery of highly conformal, dose-intense radiation to well-demarcated tumors. Special equipment and expertise are... (Review)
Review
Stereotactic radiotherapy (SRT) involves the precise delivery of highly conformal, dose-intense radiation to well-demarcated tumors. Special equipment and expertise are needed, and a unique biological mechanism distinguishes SRT from other forms of external beam radiotherapy. Families find the convenient schedules and minimal acute toxicity of SRT appealing. Common indications in veterinary oncology include nasal, brain, and bone tumors. Many other solid tumors can also be treated, including spinal, oral, lung, heart-base, liver, adrenal, and prostatic malignancies. Accessibility of SRT is improving, and new data are constantly emerging to define parameters for appropriate case selection, radiation dose prescription, and long-term follow-up."
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Medical Oncology; Neoplasms; Radiation Oncology; Radiosurgery; Radiotherapy; Radiotherapy Dosage; Veterinary Medicine
PubMed: 31253427
DOI: 10.1016/j.cvsm.2019.05.001 -
Movement Disorders : Official Journal... Jan 2017Functional radiosurgery has advanced steadily during the past half century since the development of the gamma knife technique for treating intractable cancer pain.... (Review)
Review
Functional radiosurgery has advanced steadily during the past half century since the development of the gamma knife technique for treating intractable cancer pain. Applications of radiosurgery for intracranial diseases have increased with a focus on understanding radiobiology. Currently, the use of gamma knife radiosurgery to ablate deep brain structures is not widespread because visualization of the functional targets remains difficult despite the increased availability of advanced neuroimaging technology. Moreover, most existing reports have a small sample size or are retrospective. However, increased experience with intraoperative neurophysiological evaluations in radiofrequency thalamotomy and deep brain stimulation supports anatomical and neurophysiological approaches to the ventralis intermedius nucleus. Two recent prospective studies have promoted the clinical application of functional radiosurgery for movement disorders. For example, unilateral gamma knife thalamotomy is a potential alternative to radiofrequency thalamotomy and deep brain stimulation techniques for intractable tremor patients with contraindications for surgery. Despite the promising efficacy of gamma knife thalamotomy, however, these studies did not include sufficient follow-up to confirm long-term effects. Herein, we review the radiobiology literature, various techniques, and the treatment efficacy of gamma knife radiosurgery for patients with movement disorders. Future research should focus on randomized controlled studies and long-term effects. © 2016 International Parkinson and Movement Disorder Society.
Topics: Deep Brain Stimulation; Humans; Movement Disorders; Radiosurgery; Thalamus
PubMed: 27029223
DOI: 10.1002/mds.26625 -
Physica Medica : PM : An International... Dec 2017Patient motion can cause misalignment of the tumour and toxicities to the healthy lung tissue during lung stereotactic body radiation therapy (SBRT). Any deviations from... (Review)
Review
Patient motion can cause misalignment of the tumour and toxicities to the healthy lung tissue during lung stereotactic body radiation therapy (SBRT). Any deviations from the reference setup can miss the target and have acute toxic effects on the patient with consequences onto its quality of life and survival outcomes. Correction for motion, either immediately prior to treatment or intra-treatment, can be realized with image-guided radiation therapy (IGRT) and motion management devices. The use of these techniques has demonstrated the feasibility of integrating complex technology with clinical linear accelerator to provide a higher standard of care for the patients and increase their quality of life.
Topics: Humans; Lung Neoplasms; Movement; Radiosurgery; Radiotherapy, Image-Guided
PubMed: 28647449
DOI: 10.1016/j.ejmp.2017.06.006